Before Using This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For nasal dihydroergotamine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to dihydroergotamine or any other ergot alkaloid. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Use of nasal dihydroergotamine by pregnant women may cause serious harm to the fetus. Therefore, nasal dihydroergotamine should not be used during pregnancy .

Breast-feeding—Use of nasal dihydroergotamine is not recommended for nursing mothers. Nasal dihydroergotamine may pass into the breast milk and may cause unwanted effects, such as vomiting, diarrhea, weak pulse, changes in blood pressure, or convulsions (seizures) in nursing babies. Nasal dihydroergotamine may also decrease the flow of breast milk.

Children—There is no specific information comparing use of nasal dihydroergotamine in children with use in other age groups.

Older adults—There is no specific information comparing use of nasal dihydroergotamine in older adults with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking nasal dihydroergotamine, it is especially important that your health care professional know if you are using any of the following:

• Cocaine or
• Epinephrine by injection [e.g., Epi-Pen] or
• Other ergot medicines (ergoloid mesylates [e.g., Hydergine], ergonovine [e.g., Ergotrate], methylergonovine [e.g., Methergine], methysergide [e.g., Sansert] or
• Sumatriptan [e.g., Imitrex]—The chance of serious side effects caused by nasal dihydroergotamine may be increased.

Other medical problems—The presence of other medical problems may affect the use of nasal dihydroergotamine. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart or blood vessel disease or
• Hypertension (high blood pressure) or
• Kidney disease or
• Liver disease or
• Infection—The chance of serious side effects caused by nasal dihydroergotmine may be increased. Heart or blood vessel disease and high blood pressure sometimes do not cause any symptoms, so some people do not know that they have these problems. Before deciding whether you should use nasal dihydroergotamine, your doctor may need to do some tests to make sure that you do not have any of these conditions.